SPLENECTOMY

IN IDIOPATHIC THROMBOCYTOPENIA (A RETROSPECTIVE REVIEW)

Abstract

Objective: To assess the role of splenectomy in patients of
idiopathic thrombocytopenic purpura. Design: It is a retrospective study. Place and Duration: This study was
conducted at PNS Shifa Karachi, Combined Military Hospital Lahore and Military Hospital Rawalpindi
spanning over last 10 years from 1993-2003. Subjects and methods: A total of 17 patients were included in
the study, which were diagnosed as a case of idiopathic thrombocytopenic purpura after excluding other causes
of thrombocytopenia. In all cases steroids were stopped either due to non responsiveness or severe side effects.
Splenectomy was done in all 17 patients included in the study, after immunization and maintaining the platelet
count with in near normal range by platelet transfusion. Post operative platelet count was monitored and
improvement in clinical parameters was recorded. Results: All 17 patients showed improvement in platelet
count and clinical symptom. Mortality remained zero despite of inclusion of high risk diabetics and
hypertensives. Conclusion: when steroids become ineffective, splenectomy becomes the definitive therapeutic
tool to control the effects of low platelet count.